Internal thoracic artery graft failure and recurrence of symptoms following single-vessel coronary artery bypass graft surgery

Journal of Cardiothoracic Surgery

Research

Rickard P. F. Lindblom¹  Mikael Janiec¹  Axel Dimberg² 

[1] Department of Cardiothoracic Surgery and Anesthesiology, Uppsala University Hospital, Uppsala, Sweden;Department of Surgical Sciences, Uppsala University, Uppsala, Sweden;Department of Cardiothoracic Surgery, Karolinska University Hospital, Stockholm, Sweden;

关键词: CABG;    Coronary artery bypass grafting;    ITA;    Internal thoracic artery;    Graft failure;   

DOI  :  10.1186/s13019-023-02384-1

 received in 2022-02-25, accepted in 2023-09-30,  发布年份 2023

来源: Springer

【 摘 要 】

ObjectivesCoronary events and disease recurrence following coronary artery bypass (CABG) surgery could derive from either failure in the internal thoracic artery (ITA) graft, failure in other conduits or progressive disease in the coronaries. We aim to estimate the contribution of ITA graft failure to the recurrence of symptoms after CABG surgery.MethodsWithin the Swedish Web System for Enhancement and Development of Evidence-Based Care in Heart Disease Evaluated According to Recommended Therapies registry, we identified patients who had coronary artery bypass grafting from 1997 to 2020 with a single-vessel ITA graft bypass. Deaths, postoperative incidence of coronary angiography and the presence of a failed graft at the time of the angiography were recorded.ResultsThe study population consisted of 1939 patients with a mean follow-up time (SD) of 17.2 (5.6) years. The cumulative incidence (95% CI) at 20 years for a first clinically-driven postoperative angiography was 38.6% (36.2–41.1). A failed ITA graft was reported in 16.4% of the angiographies.ConclusionsA substantial part of recurrent symptoms of coronary artery disease do not seem to be related to ITA failure. Disease progression in the native coronary vessels may instead be the main driver of symptom recurrence.

【 授权许可】

CC BY   
© BioMed Central Ltd., part of Springer Nature 2023

【 图 表 】

Fig. 4